198011217-7-7-2021-54-CC-AMOY-C4Q2GF-20210707172304

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011217
Report Date: 07/07/2021
Date Signed: 07/07/2021 05:23:16 PM

Document Has Been Signed on 07/07/2021 05:23 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	SIMPSON-GIPSON FAMILY CHILD CARE		FACILITY NUMBER:	198011217
ADMINISTRATOR:	SIMPSON-GIPSON, DEBRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 329-3270
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 6	DATE:	07/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Debra Simpson-Gipson, Licensee		TIME COMPLETED:	05:30 PM

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On 7/7/21 at 1:45pm Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual inspection to ensure the health & safety as required by regulations governing family child care homes are being met. Upon arrival, LPA met with Zakeya Edison, Assistant, who provide a tour of the facility. LPA observed 8 children napping in the living room (main daycare area). LPA informed assistant of nature of the visit. Debra Gipson-Simpson, Licensee, arrived at the home at 2:00pm. LPA confirmed that all adults residing/working in the home have criminal record clearance.

The facility was toured indoors and outdoors. This is a one story home consisting of 3 bedrooms and 1 bathroom, living room, kitchen, family room at the back of the home. There is a back house connected to the detached garage, licensee states it is used as a romper room and no children are allowed inside.

Off limit areas include: The bedrooms (observed to be locked), kitchen, detached garage, back house w/ bathroom and back yard.

Fire extinguisher size 2A10BC was observed with service tag dated 9/21/20. The smoke detector and carbon monoxide detectors were tested and found operable. LPA observed wall and floor heaters to be screened in the living room and hallway. Sharp objects, toxins and hazardous materials are inaccessible to children in the kitchen, bathroom and garage. LPA observed an Infant First Aid/CPR certifications for Assistant Expiration date 10/12/21. LPA observed age appropriate toys, napping equipment, first aid kit and emergency supplies. Children's records were reviewed and records are maintained for each child, a copy of emergency information card that contains all of the information specified by regulations.

No bodies of water were observed on the premises.The licensee is observed to be operating within the license capacity limitations.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
	VISIT DATE: 07/07/2021

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Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in a prominent location.
No guns or ammunition are in the home per the licensee and none observed by the LPA.
Currently, children are using the side yard (in front of the garage) for outdoor play time. The outdoor play area was observed to be fenced and free of hazards with toys and other materials for children to play with.

The licensee and other personnel have completed training on preventive health practices including Pediatric Firs Aid/CPR. The licensee's Pediatric First Aid and CPR expires on 6/24/23.
The licensee has proof of immunization against influenza, pertussis, and measles.
LPA observed Licensee has proof of the Mandated Reporter AB 1207 Certificate completed on 4/28/21.
The following was discussed:
- All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on June 4, 2021

- The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise children in their absence.

- All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home.

-Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Licensee was reminded to use car seats and high chairs for their intended purpose. Car seats shall never be used for sleeping. Licensee has 2 small dogs at this time. LPA observed the dogs in the off limit bedroom.

COVID -19 - LPA discussed the latest COVID-19 guidelines including face mask and social distancing guidance for licensed facilities. LPA advised licensee to stay informed by visiting www.covid19.ca.gov.

Licensee has no Infants 12 months or under in care. Licensee has the required LIC 9227 available should infants 12 months or younger are enrolled. Licensee was advised completed Infant sleep log for infant 12 months and under. Page 2

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
	VISIT DATE: 07/07/2021

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Safe Sleep Regualtions:
LPA observed 1 crib used for sleeping infants. Licensee was advised to sleep infant (12 months and under) on their back, no loose fitting clothing, objects or articles in crib or play yard.
- Cribs or play yards shall be free from all loose articles and objects.
- If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times.

LPA provided and discussed PIN-20-24-CCP Safe Sleep Regulations with licensee. LPA provided licensee with the Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA also consulted and explained Child Abuse Reporting, provided Complaint Hotline information, Never Shake a Baby and Large childcare capacity handout.

Incidental Medical Services (IMS):
Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised licensee to sign up to receive regulations and quarterly updates from CDSS. Licensee states they are familiar with accessing forms and PINS online at: www.cdss.ca.gov.

Based on the LPA’s observations and records review, no deficiencies are being cited during this inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Debra Simpson-Gipson, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

End of Report

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021

LIC809 (FAS) - (06/04)

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